It can be challenging to detect syringomyelia in patients with scoliosis, as some cases are mildly symptomatic with little to no neurological deficits. However, a timely diagnosis of syringomyelia is needed to facilitate important treatment considerations. This case report details an 11-year-old female with mild scoliosis and a two-year history of spinal pain that had short-term symptomatic relief from chiropractic treatment. Subtle neurological signs were detected only at re-evaluation, which prompted further investigation with radiographs and subsequent magnetic resonance imaging (MRI). MRI revealed a non-expansile syrinx measuring 3 mm at its widest diameter that extended from C5 to the conus medullaris. The aim of this case is to heighten awareness of the potential diagnostic challenges in patients with syringomyelia and scoliosis. The incidence, pathogenesis, clinical presentation, and management of syringomyelia will be presented to help primary contact providers with appropriate referral and co-management of these patients.

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AP lower (A) cervical radiograph revealed scalloping at the left lateral border of the C4 vertebral body (arrow). Lateral radiograph (B) of the cervical spine revealed scalloping of the anterior edges of the spinolaminar at C5, C6 and C7 (arrows), considered to be likely a normal variant.